Becoming the temporary surgeon: A grounded theory examination of anaesthetists performing emergency front of neck access in inter-disciplinary simulation-based training.

Sergio A. Silverio, Hilary Wallace, William Gauntlett, Richard Berwick, Simon Mercer, Ben Morton, Simon N. Rogers, John Sandars, Peter Groom, Jeremy M. Brown

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
149 Downloads (Pure)

Abstract

The time-critical ‘can’t intubate, can’t oxygenate’ [CICO] emergency post-induction of anaesthesia is rare, but one which, should it occur, requires Anaesthetists to perform rapid emergency front of neck access [FONA] to the trachea, restoring oxygenation, and preventing death or brain hypoxia. The UK Difficult Airway Society [DAS] has directed all Anaesthetists to be trained with surgical cricothyroidotomy [SCT] as the primary emergency FONA method. We present a longitudinal analysis using a classical approach to Grounded Theory methodology of ten Specialist Trainee Anaesthetists’ data during a 6-month training programme delivered jointly by Anaesthetists and Surgeons. We identified with a critical realist ontology and an objectivist epistemology meaning data interpretation was driven by participants’ narratives and accepted as true accounts of their experience. Our theory comprises three themes: ‘Identity as an Anaesthetist’; ‘The Role of a Temporary Surgeon’; and ‘Training to Reconcile Identities’, whereby training facilitated the psychological transition from a ‘bloodless Doctor’ (Anaesthetist) to becoming a ‘temporary Surgeon’. The training programme enabled Specialist Trainees to move between the role of control and responsibility (Identity as an Anaesthetist), through self-described ‘failure’ and into a role of uncertainty about one’s own confidence and competence (The Role of a Temporary Surgeon), and then return to the Anaesthetist’s role once the airway had been established. Understanding the complexity of an intervention and providing a better insight into the training needs of Anaesthetic trainees, via a Grounded Theory approach, allows us to evaluate training programmes against the recognised technical and non-technical needs of those being trained.
Original languageEnglish
Article numbere0249070
Pages (from-to)1-20
JournalPLoS ONE
Volume16
Issue number3
Early online date23 Mar 2021
DOIs
Publication statusPublished - 23 Mar 2021

Keywords

  • Anaesthesia
  • Anaesthetic Training
  • Anaesthetists
  • Clinical Education
  • Clincial Practice
  • Cross-Disciplinary Research
  • Grounded Theory
  • Medical Education
  • Medical Intervention
  • Professional Identity
  • Psychological Experience
  • Qualitative Interviews
  • Simulation Training
  • Surgical Practice

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